International Journal of Clinical and Experimental Medical Sciences
Volume 3, Issue 6, November 2017, Pages: 78-81
Received: May 11, 2017;
Accepted: May 22, 2017;
Published: Nov. 28, 2017
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Mohammed El Idrissi, Department of Orthopeadic Surgery B4, Hassan II University Hospital, Fez, Morocco
Abdelhalim Elibrahimi, Department of Orthopeadic Surgery B4, Hassan II University Hospital, Fez, Morocco
Abdelmajid Elmrini, Department of Orthopeadic Surgery B4, Hassan II University Hospital, Fez, Morocco
The influence of individual acromial morphology on the pathogenesis of rotator cuff tears remains controversial. Since Neer first described the impingement syndrome, several authors have described the morphology of the acromion. In this study, we try to find a physiopathological correlation between the anatomical morphology of the acromion based on these two recently descripted parameters (Acromial index and Critical Shoulder Angle) and rotator cuff tears. Thirty-six consecutive conventional rotator cuff repair patients were retrospectively reviewed at our institution. Standardized, true anteroposterior radiographs with the arm in the neutral position were used to assess the acromion index, and the critical shoulder angle according. On standardized outlet views, the acromion morphology was classified according to Bigliani and Morrison. The acromion was flat in 2 patients (6%), curve (type 2) in eight patients, and hooked. The mean acromial index was 0.7. The mean critical shoulder angle was 37°. Acromial morphology plays without any doubt an important role in the pathogenesis impingement and its evolution to cuff rotator tears. The results of our study confirm the importance of a more comprehensive evaluation of the morphology of the acromion, which take in consideration not only acromial shape, but especially its lateral extension evaluated by the acromial index and the critical angle of the shoulder.
Mohammed El Idrissi,
Relationship of Acromial Morphology and Rotator Cuff Integrity, International Journal of Clinical and Experimental Medical Sciences.
Vol. 3, No. 6,
2017, pp. 78-81.
Neer CS 2nd (1972) Anterior acromioplasty for the chronic impingement syndrome in the shoulder: a preliminary report. J Bone Joint Surg Am 54 (1): 41–50.
Bigliani LU, Morrison DS, April EW (1986) The morphology of the acromion and its relationship to rotator cuff tears. Orthop Trans 10: 228.
Aoki M, Ishii S, Usui M (1986) The slope of the acromion and rotator cuff impingement. Orthop Trans 10: 228.
Banas MP, Miller RJ, Totterman S (1995) Relationship between the lateral acromion angle and rotator cuff disease. J Should Elbow Surg 4 (6): 454–461.
Nyffeler RW, Werner CM, Sukthankar A, Schmid MR, Gerber C. Association of a large lateral extension of the acromion with rotator cuff tears. J Bone Joint Surg Am. 2006 Apr; 88 (4): 800-5.
Moor BK, Bouaicha S, Rothenfluh DA, Sukthankar A, Gerber C. Is there an association between the individual anatomy of the scapula and the development of rotator cuff tears or osteoarthritis of the glenohumeral joint?: A radiological study of the critical shoulder angle. Bone Joint J. 2013 Jul; 95-B (7): 935-41.
Nicholson GP, Goodman DA, Flatow EL, Bigliani LU. The acromion: morphologic condition and age-related changes. A study of 420 scapulas. J Shoulder Elbow Surg 1996; 5:1-11.
Ozaki J, Fujimoto S, Nakagawa Y, Masuhara K, Tamai S. Tears of the rotator cuff of the shoulder associated with pathological changes in the acromion.A study in cadavera. J Bone Joint SurgAm 1988; 70: 1224-30.
Wang JC, Shapiro MS. Changes in acromial morphology with age. J Shoulder Elbow Surg 1997; 6: 55-9.
Moor BK, Wieser K, Slankamenac K, Gerber C, Bouaicha S. Relationship of individual scapular anatomy and degenerative rotator cuff tears. Shoulder Elbow Surg. 2014 Apr; 23 (4): 536-41.
Chansky HA, Iannotti JP (1991) The vascularity of the rotator cuff. Clin Sports Med 10 (4): 807–822.
Nixon JE, DiStefano V (1975) Ruptures of the rotator cuff. Orthop Clin North Am 6 (2): 423–447.
Bigliani LU, Ticker JB, Flatow EL, Soslowsky LJ, Mow VC (1991) Relationship of acromial architecture and diseases of the rotator cuff. Orthopade 20 (5): 302–309.
Toivonen DA, Tuite MJ, Orwin JF (1995) Acromial structure and tears of the rotator cuff. J Should Elbow Surg 4 (5): 376–383.
Hayes PR, Flatow EL (2002) Attrition sign in impingement syndrome. Arthroscopy 18 (9): E44.
Ouellette H, Labis J, Bredella M, Palmer WE, Sheah K, Torriani M (2008) Spectrum of shoulder injuries in the baseball pitcher. Skeletal Radiol 37 (6): 491–498. doi:10.1007/s00256-007-0389-0.
Balke M, Schmidt C, Dedy N, Banerjee M, Bouillon B, Liem D (2013) Correlation of acromial morphology with impingement syndrome and rotator cuff tears. Acta Orthop 84 (2), 178–183.
Jacobson SR, Speer KP, Moor JT, Janda DH, Saddemi SR, MacDonald PB, Mallon WJ (1995) Reliability of radiographic assessment of acromial morphology. J Shoulder Elbow Surg 4 (6), 449–453.
Zuckerman JD, Kummer FJ, Cuomo F, Greller M (1997) Interobserver reliability of acromial morphology classification: an anatomic study. J Shoulder Elbow Surg 6, 286–287.
Hamid N, Omid R, Yamaguchi K, Keener JD (2012) Relationship of radiographic acromial characteristics and rotator cuff disease: a prospective investigation of clinical, radiographic, and sonographic findings. J Shoulder Elbow Surg 21 (10), 1289–1298.
A Denis, J Vial, N Sans, O Loustau, H Chiavassa-Gandois et J-J Railhac Radiographies de l’épaule: les incidences utiles en pratique courante. J Radiol 2008; 89: 620-32.
Kim JR, Ryu KJ, Hong IT, Kim BK, Kim JH. Can a high acromion index predict rotator cuff tears? Int Orthop 2012; 36: 1019-24.
Miyazaki AN, Itoi E, Sano H, Fregoneze M, Santos PD, da Silva LA, et al. Comparison between the acromion index and rotator cuff tears in the Brazilian and Japanese populations. J Shoulder Elbow Surg 2011; 20: 1082-6.
Musil D, Sadovsky P, Rost M, Stehlik J, Filip L. Relationship of acromial morphology and rotator cuff tears. Acta Chir Orthop Traumatol Cech 2012; 79: 238-42.
Torrens C, Lopez JM, Puente I, Caceres E. The influence of the acromial coverage index in rotator cuff tears. J Shoulder Elbow Surg 2007; 16: 347-51. http://dx.doi.org/10.1016/j.jse.2006.07.006.
Zumstein MA, Jost B, Hempel J, Hodler J, Gerber C. The clinical and structural long-term results of open repair of massive tears of the rotator cuff. J Bone Joint Surg Am 2008; 90:2423-31. http://dx.doi.org/10.2106/JBJS.G.00677.
Li X et al. Relationship between acromial morphological variation and subacromial impingement: A three-dimensional analysis. PLoS One. 2017 Apr 25; 12 (4): e0176193. doi:10.1371/journal.pone.0176193.
Kirsch JM, Nathani A, Robbins CB, Gagnier JJ, Bedi A, Miller BS. Is There an Association Between the "Critical Shoulder Angle" and Clinical Outcome After Rotator Cuff Repair? Orthop J Sports Med. 2017 Apr 18; 5 (4): 2325967117702126. doi: 10.1177/2325967117702126.